@layout("/common/_form.html",{js:["/assets/waterMeterRepairInfo/waterMeterRepairInfo_edit.js"]}){

<form class="layui-form" id="waterMeterRepairInfoForm" lay-filter="waterMeterRepairInfoForm">
    <div class="layui-fluid" style="padding-bottom: 75px;">
        <div class="layui-card">
            <div class="layui-card-header">基本信息</div>
            <div class="layui-card-body">
                <div class="layui-form-item layui-row">
                    <input name="id" type="hidden"/>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">标题<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="title" name="title" placeholder="标题" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">所处区域<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <select id="region" name="region" placeholder="请选择所处区域">
                                <option value="">所处区域</option>
                                <option value="城市">城市</option>
                                <option value="农村">农村</option>
                            </select>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">联系人姓名<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="name" name="name" placeholder="请输入联系人姓名" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">联系人电话<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="phone" name="phone" placeholder="请输入联系人电话" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">用水地址<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="address" name="address" placeholder="请输入用水地址" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">备注<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="remarks" name="remarks" placeholder="请输入备注" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">报修项目<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="repairItems" name="repairItems" placeholder="请输入报修项目" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
<!--                    <div class="layui-inline layui-col-md12">-->
<!--                        <label class="layui-form-label">身份证正<span style="color: red;">*</span></label>-->
<!--                        &lt;!&ndash;                        <div class="layui-input-block">&ndash;&gt;-->
<!--                        &lt;!&ndash;&lt;!&ndash;                            <input id="idCardOriginal" name="idCardOriginal" placeholder="请输入身份证正" type="text" class="layui-input" lay-verify="required" required/>&ndash;&gt;&ndash;&gt;-->
<!--                        &lt;!&ndash;                        </div>&ndash;&gt;-->
<!--                        <div class="layui-input-block">-->
<!--                            <button type="button" class="layui-btn" id="uploadPhoto">-->
<!--                                <i class="layui-icon">&#xe67c;</i>上传图片-->
<!--                            </button>-->
<!--                            <div class="layui-upload-list">-->
<!--                                <img class="layui-upload-img" id="photoView"-->
<!--                                     style="height: 150px;width: 150px">-->
<!--                                <p style="width: 150px;" align="center">图片预览</p>-->
<!--                            </div>-->
<!--                            <input id="idCardOriginal" name="idCardOriginal" type="hidden" class="layui-input"/>-->
<!--                        </div>-->
<!--                    </div>-->
<!--                    <div class="layui-inline layui-col-md12">-->
<!--                        <label class="layui-form-label">身份证反<span style="color: red;">*</span></label>-->
<!--                        &lt;!&ndash;                        <div class="layui-input-block">&ndash;&gt;-->
<!--                        &lt;!&ndash;                            <input id="idCardCounter" name="idCardCounter" placeholder="请输入身份证反" type="text" class="layui-input" lay-verify="required" required/>&ndash;&gt;-->
<!--                        &lt;!&ndash;                        </div>&ndash;&gt;-->
<!--                        <div class="layui-input-block">-->
<!--                            <button type="button" class="layui-btn" id="uploadImg">-->
<!--                                <i class="layui-icon">&#xe67c;</i>上传图片-->
<!--                            </button>-->
<!--                            <div class="layui-upload-list">-->
<!--                                <img class="layui-upload-img" id="photoViewCounter"-->
<!--                                     style="height: 150px;width: 150px">-->
<!--                                <p style="width: 150px;" align="center">图片预览</p>-->
<!--                            </div>-->
<!--                            <input id="idCardCounter" name="idCardCounter" type="hidden" class="layui-input"/>-->
<!--                        </div>-->
<!--                    </div>-->
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">现场照片<span style="color: red;">*</span></label>
                        <!--                        <div class="layui-input-block">-->
                        <!--                            <input id="scenePhotos" name="scenePhotos" placeholder="请输入现场照片" type="text" class="layui-input" lay-verify="required" required/>-->
                        <!--                        </div>-->
                        <div class="layui-input-block">
                            <button type="button" class="layui-btn" id="uploadScenePhotos">
                                <i class="layui-icon">&#xe67c;</i>上传图片
                            </button>
                            <div class="layui-upload-list">
                                <img class="layui-upload-img" id="scenePhotosView"
                                     style="height: 150px;width: 150px">
                                <p style="width: 150px;" align="center">图片预览</p>
                            </div>
                            <input id="scenePhotos" name="scenePhotos" type="hidden" class="layui-input"/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">其他照片<span style="color: red;">*</span></label>
                        <!--                        <div class="layui-input-block">-->
                        <!--                            <input id="otherPhotos" name="otherPhotos" placeholder="请输入其他照片" type="text" class="layui-input" lay-verify="required" required/>-->
                        <!--                        </div>-->
                        <div class="layui-input-block">
                            <button type="button" class="layui-btn" id="uploadOtherPhotos">
                                <i class="layui-icon">&#xe67c;</i>上传图片
                            </button>
                            <div class="layui-upload-list">
                                <img class="layui-upload-img" id="otherPhotosView"
                                     style="height: 150px;width: 150px">
                                <p style="width: 150px;" align="center">图片预览</p>
                            </div>
                            <input id="otherPhotos" name="otherPhotos" type="hidden" class="layui-input"/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">处理进度<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <!--                            <input id="tag" name="tag" placeholder="请输入处理进度" type="text" class="layui-input" lay-verify="required" required/>-->
                            <select id="tag"  name="tag" placeholder="请选择处理进度">
                                <option value="">审核状态</option>
                                <option value="未处理">未处理</option>
                                <option value="处理中">处理中</option>
                                <option value="已处理">已处理</option>
                            </select>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
    <div class="form-group-bottom text-center">
        <button class="layui-btn" lay-filter="btnSubmit" lay-submit>&emsp;提交&emsp;</button>
        <button type="reset" class="layui-btn layui-btn-primary" ew-event="closeDialog">&emsp;取消&emsp;</button>
    </div>

</form>

@}